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Biomedical subjects

J Spikes

Publications and source records attributed to J Spikes.

7 recordsLinked to original sources
PubMed1986

Ombudsman rounds revisited--a controlled study of attitudinal change in response to liaison psychiatry teaching.

The authors tested the hypothesis that the attitudes of interns in internal medicine could be positively altered by a weekly medical-psychiatric conference (ombudsman rounds) that is given for 4 months on the inpatient medical service. In order to diminish the effects of simulation a 48-item questionnaire using a Q-sort design was employed. It was given both before and after the PGY-1 year to three groups of house staff: 1) an on-site experimental group (29 subjects), 2) an on-site control group (11 subjects), and 3) an off-site control group from a sister institution (13 subjects). When compared with either control group a statistically significant number of subjects in the experimental group changed positively. When the control groups were combined even greater statistical significance was achieved. The data suggest that attitudes of internal medicine trainees may be favorably altered by medical-psychiatric conferences on inpatient wards.

Attitude of Health Personnel↗
PubMed1985

Informed consent--mandating the consultation.

This article illustrates how a mandatory consult procedure identified treatable psychiatric problems. Using a computerized data-based format, 372 (37.4%) patients (the "judgment" group) of 996 psychiatric consultations were identified as referred to assess the patient's capacity to execute a consent form for a medical or surgical procedure. One hundred twenty-nine (35%) of the 372 patients thus referred by hospital mandate were given psychiatric diagnoses (DSM-II) by the consultant and received recommendations for primary psychiatric treatment. The "judgment" group had significantly more organic brain syndrome and psychoses associated with CNS conditions (p less than 0.001), whereas the "nonjudgment" group was diagnosed as exhibiting significantly more neurosis, alcoholism, psychophysiologic disorders, transient situational reactions, and personality disorders (p less than 0.001). Without a required psychiatric consultation sanctioned by administrative hospital mandate, the majority of the "judgment" cases with major psychopathology would not have been identified. The use of the mandated psychiatric consultation in the general hospital is discussed.

Aged↗
PubMed1979

The effects of a psychiatric liaison program on the utilization of psychiatric consultations: an evaluation by chart audit.

The effects of a psychiatric liaison program were studied by a chart audit examination of psychiatric consultations on a medical service. A comparison of the full liaison ward with the other wards revealed significant differences in the use of emergency consultation and psychiatric follow-up treatment. The results indicated improved psychologic management of medical patients on wards with intense liaison involvement but no measurable change in attitude toward the psychiatrist. Evaluation methodology and implications of the results are discussed.

Adult↗
PubMed1979

Recording psychiatric consultations: a preliminary report.

Two new forms, specifically designed for computer processing of data from a contemporary consultation-liaison service, are described. The need for such data and their immediate applicability to problems currently facing this psychiatric subspecialty are discussed. Clinical, administrative, and evaluation uses are reviewed. It is hoped that this work will provide a stimulus to consultation-liason practitioners to use this system or to develop similar systems that will permit documentation, exploration, and enhancement of the consultation-liaison effort.

Adult↗